Case Manager

Bayshore HealthCare; Mississauga; Hybrid; CAD 54,000 - 68,000; Part time

Job summary

The Bayshore HealthCare Case Manager in Mississauga is a contract role offering reimbursement support and direct patient assistance. You will help patients, physicians and nurses complete program paperwork, navigate private and public payer options, and support access to therapy with a focus on timely, compassionate service.

This position requires bilingual English/French communication, strong data entry and documentation skills, and the ability to work autonomously in a remote/virtual team

Qualifications

• Post-secondary education or equivalent required.
• Bilingual proficiency in French and English (spoken and written).
• Strong customer service and interpersonal skills.

Responsibilities

• Assist patients and physicians with reimbursement-related paperwork.
• Enrol patients in the patient support program and provide reimbursement navigation.
• Coordinate with pharmacists, physicians, nurses and PSP team for optimal patient support.
• Maintain accurate records and ensure timely reporting of required data.

Skills

Bilingual English/French

Customer service

Data entry

Communication

Education

Post-secondary education

Tools

Excel

Word

Outlook

Job description

| Job Description | | | | --- | --- | | Case Manager(Job Number: 26005523) Primary Location:ON-Mississauga Administration Employee Type:Contract Pay Rate From:$54,000 Pay Rate To:$67,500 Description : *This is a contract opportunity with an anticipated end date of January 2027.* **JOB SUMMARY** The Case Manager (CM) is expert point of contact offering case management support services to patients and physicians. The CM will assist the patients, physicians, and nurses with the completion of all program-specific paperwork. The CM will act as a resource to physicians who are prescribing medications and patients who need on-going support. They are instrumental in removing any reimbursement access barriers to treatment for patients, thereby ensuring that they can start on therapy as quickly as possible. They thrive in an environment that emphasizes teamwork and accountability, possesses a deep willingness to serve customers, and drives positive customer experiences in a fast‐paced work environment while showing flexibility to adapt to competing demands across the portfolio as required. **DUTIES AND RESPONSIBILITIES** • Ensure patient has been enrolled in the patient support program (PSP). Set the tone for a warm welcome into the program. • Provide direct telephone assistance to patients requiring reimbursement support. • Provide patients and physicians with direct toll-free number. • Develop strong relationships with patients, caregivers, and their healthcare team by infusing confidence, trust, security, and relief. • Facilitate a patient’s access to a particular medication by offering reimbursement navigation services. • Investigate reimbursement options available to the patient and maximize the patient’s coverage via private and public payers, while minimizing the financial assistance offered through the PSP and/or out-of-pocket expenses for the patient. • Represent the patient with private or public insurers to optimize drug coverage and assist with the completion of Special Authorization (SA) and/or Prior Authorization (PA) forms, when applicable. • Coordinate with pharmacy drug coverage and dispensing. Troubleshoot any filling/billing issues as required • Liaise with PSP team to ensure optimal patient support and communication, if applicable. • Maintain ongoing and transparent communication with the patient’s healthcare team. • Diligent record-keeping to ensure continuous care and exceptional customer and patient experience. • Uncover and proactively identify gaps and opportunities for improvement in patient experience. • Through patient-oriented solutions, manage challenging patient situations with empathy and patience. • Work with the site representatives to support specific customer needs. • Act as a central resource liaison for program stakeholders, which include physicians, nurses, patients, and clinics. • Provide updates to internal and external stakeholders as requested and required. • Perform data entry, answer inbound calls, make outbound calls, manage e-mail and fax software, and perform general administrative functions including faxing and filing. • Ensure timely and compliant reporting of Adverse Events (AEs) and Product Quality Complaints (PQCs) in accordance with Health Canada pharmacovigilance requirements and guidelines, including accurate documentation, appropriate escalation, and effective collaboration with internal stakeholders and regulatory teams. • Participate in ongoing internal and/or external continuing education activities. • Adhere to Bayshore Policies and Procedures. • Participate in quality activities and continuous improvement initiatives in keeping with the company’s Quality Management System as well as specific performance indicators for the project. • Participate in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate supervisor of any Health & Safety risks or concerns. • Maintains confidentiality of pharmaceutical partner(s) and corporate information and discusses same only with appropriate Bayshore personnel. • Complete other tasks as requested. Qualifications : **QUALIFICATIONS** • Completion of post-secondary education or equivalent. • Understanding of provincial and private coverage criteria, Special Authorization processes and how to navigate the Canadian drug coverage landscape is an asset • Demonstrated expertise in delivering exceptional customer service and fostering positive relationships with internal and external stakeholders • This position requires bilingual proficiency in French and English (spoken and written) due to operational, client, and regulatory requirements. • Experience in the healthcare, pharmaceutical, or insurance industry would be an asset • Strong customer service, communication, problem-solving and interpersonal skills required. • Demonstrates sensitivity and commitment to utilizing a patient-centric approach; is adept to responding to a patient’s emotional, educational, and health literacy needs • Making decisions using sound judgment, and meeting deadlines. • Ease of working in a paperless environment. • Mindful of accuracy and thoroughness of data entry for reporting requirements. • Strong sense of organization, attention to detail, and ability to multi-task. • Excellent written and verbal communication and interpersonal skills. • Strong computer and technical skills: Excel, Word, Outlook, tablets, web portals/internet use • Ability to work in a quiet working environment with proven ability to work autonomously within a remote/virtual team environment • Established high speed internet access from home office. • Flexibility to adapt and learn multiple programs based on demand. **ADDITIONAL REQUIREMENTS** • Occasional travel may be required At Bayshore Healthcare, our commitment to Equity, Diversity & Inclusion is our strength. This is how we bring our vision of being the difference in the lives of those we care for, work with and in our communities. We have a great sense of pride in creating a culture of belonging, where individual differences are embraced and celebrated, through programs, resources and policies that support each individual's purpose, potential and wellbeing. At Bayshore Healthcare Ltd., and its subsidiaries, we are committed to fostering an inclusive workplace and operate in full compliance with all Provincial and Territorial legislation pertaining to Human Rights Codes and Accessibility requirements. To ensure continued compliance throughout the recruitment and selection process, we encourage candidates to disclose any accommodation needs they may have. | | |